Comparative analysis of monolateral and bilateral spinal anesthesia

Abstract

AIM: This study aimed to improve the treatment results of patients with diabetic foot syndrome by substantiating the optimal type of spinal anesthesia during foot surgery.

MATERIALS AND METHODS: Sixty-four patients undergoing purulent surgery were examined and group as follows: Group 1 – patients operated on under monolateral (unilateral) spinal anesthesia and Group 2 – patients operated on under conditions of bilateral (traditional) spinal anesthesia.

RESEARCH METHODS: Assessment of the level and intensity of pain and the level of catecholamines in urine was conducted in the first postoperative day. Cardiovascular system indicators and the temperature of the skin of the leg during anesthesia were monitored, and the Doppler scanning of peripheral circulation in the foot was performed.

RESULTS: Pain sensitivity during lower limb movement was 20% less pronounced in group 1 than in group 2. A 4.4% decrease in heart rate, a 4.7% decrease in saturation level recorded 20 minutes after the onset of anesthesia, and a 9.8% decrease in mean arterial pressure were observed in group 2. In both groups, systolic blood pressure in the toe increased by 18% after anesthesia, and the temperature of the skin on the lateral surface of the leg increased by 3%. Adrenaline concentration in the daily portion of urine in group 2 was 34.4% higher than that in group 1 in the next postoperative day.

CONCLUSIONS: The general condition of patients during anesthesia was more stable in group 1 than in group 2. After anesthesia, improved peripheral hemodynamics in the operated limb was noted. Compared with traditional spinal anesthesia, monolateral spinal anesthesia has a positive effect on the stress response of the patient’s body to surgical intervention.

Keywords

diabetic foot syndrome / regional anesthesia / monolateral spinal anesthesia / bilateral spinal anesthesia

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